Coronary artery ectasia is characterized by the enlargement of a coronary artery to 1.5 times or more than its normal diameter. The disease is commonly asymptomatic and is normally discovered when performing tests for other conditions such as coronary artery disease, stable angina and other acute coronary syndromes. It is attributed to atherosclerosis in 50% of cases, whereas 20%-30% are considered to be congenital in origin. In the great majority of these patients, ectasia coexists with CAD. Only 10% -20% of CAE have been described in association with inflammatory or connective tissue disease.

Coronary artery ectasia is characterized by the enlargement of a coronary artery to 1.5 times or more than its normal diameter. The disease is commonly asymptomatic and is normally discovered when performing tests for other conditions such as coronary artery disease, stable angina and other acute coronary syndromes. It is attributed to atherosclerosis in 50% of cases, whereas 20%-30% are considered to be congenital in origin. In the great majority of these patients, ectasia coexists with CAD. Only 10% -20% of CAE have been described in association with inflammatory or connective tissue disease.

Coronary artery ectasia occurs 4 times more frequently in males than in females and in people who have risk factors for heart disease such as smokers. While the disease is commonly found in patients with atherosclerosis and coronary artery disease, it can occur by itself and in both cases, it can cause health problems. The disease can cause the heart tissue to be deprived of blood and die due to decreased blood flow, and blockages due to blood clots or spasms of the blood vessel. This blood flow disruption can cause permanent damage to the muscle if the deprivation is prolonged. Coronary artery ectasia also increases the chance of developing large weak spots in the affected coronary arteries, or aneurysms that can rupture and result in death. The damage can result in angina which is pain in the chest and is a common complaint in these patients. The underlying mechanism of coronary ectasia is not well-understood. In adult patients, most of coronary artery aneurysms and coronary artery ectasias are caused by atherosclerosis or vessel wall injury after a coronary intervention

Treatment: There are currently no cardiovascular society guidelines or recommendations for the treatment of coronary artery ectasia. Experts in the field urge clinicians to consider anti-platelet therapy, such as Aspirin, to reduce thrombus formation in pocket vortices associated with turbulent blood flow. Dual anti-platelet therapy and full anticoagulation are currently under investigation.

The primary etiology of coronary ectasia in adults is atherosclerosis, thus treatment with statin therapy should be considered. Statin therapy may also reduce inflammation and matrix metalloproteinase activation which may reduce the progression of vessel ectasia. Some studies have also suggested the use of angiotensin converting enzyme inhibitors, as ACE gene polymorphisms have been implicated in disease progression. Risk factor modification is recommended; including tobacco cessation, blood pressure control and avoidance of illicit substance use, specifically cocaine.

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Current Trends in Cardiology

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